- What do I need to know about pain control?
- Facts about cancer pain treatment
- What causes pain in people with cancer?
- Treating cancer pain
- Developing a plan for pain control
- Keep a record of your pain.
- Your type of pain affects the treatment you will need.
- Learning about breakthrough pain
- What if I need a different pain medicine?
- Medicines used to relieve pain
- Common questions about taking pain medicines
- Non-opioid pain medicines
- Non-steroidal anti-inflammatory drugs
- Opioid pain medicines
- Other types of pain medicine
- Other medical methods to relieve pain
- Non-medical treatments for pain
- Skin stimulation
- Emotional support and counseling
- Research on pain control methods
- Additional resources
What causes pain in people with cancer?
Pain is most often caused by the cancer itself. But pain can also be caused by the treatment or the tests done to diagnose cancer. You may also have pain that has nothing to do with your cancer or its treatment. Like anyone, you can get headaches, muscle strains, and other aches and pains.
Pain from the cancer
Whether you have pain and the amount of pain you have depends on the type of cancer, its stage (extent), and your pain threshold (tolerance for pain). Most of the pain occurs when a tumor presses on bones, nerves, or body organs. People with advanced cancer are more likely to have pain.
Spinal cord compression: When a tumor spreads to the spine, it can press on the spinal cord. This is called spinal cord compression. The first sign of the compression is usually back and/or neck pain, sometimes with pain or weakness in an arm or leg. Coughing, sneezing, or other movements often make it worse. If you have this pain, get help right away. This compression must be treated quickly to keep you from losing control of your bladder or bowel or being paralyzed. Your doctor can treat the cause of the pain and also give you medicine to relieve the pain. If you are treated for the compression soon after the pain begins, you can usually avoid serious outcomes such as bladder or bowel problems. Treatments usually involve radiation therapy to shrink the tumor. Or you may have surgery to remove the tumor, which is then followed by radiation.
Bone pain: This type of pain can happen when cancer spreads to the bones. Treatment may be aimed at controlling the cancer, or it can focus on the affected bones. External radiation may be aimed at the weakened bone. Sometimes a radioactive medicine is given that settles in the affected areas of bone and helps to make them stronger. Bisphosphonates are other medicines that can help make diseased bones stronger and help keep bones from breaking. These are examples of treatments that are aimed at stopping the cause of the bone pain. You may still need opioids or other pain medicines, but sometimes these treatments can greatly reduce your pain.
Pain from procedures and surgery
Procedures and testing: Some tests used to diagnose cancer and to see how well the treatment is working are painful. If you and your doctors agree that such a procedure is needed, concern about pain should not keep you from having it done. Any pain you have during and after the procedure can usually be relieved. Your needs and the type of procedure to be done should dictate the kinds of medicine you can get for the pain. You may be told that the pain from the procedure can't be avoided or that it won't last long. Even so, you should ask for pain medicine if you need it.
Surgical pain: Surgery is often used to treat cancers that grow as solid tumors, but other treatments such as radiation or chemotherapy may also be given. Depending on the kind of surgery you have, some amount of pain is usually expected. Doctors prescribe pain medicines so that you do not have to be in pain when your surgery is over. If you tell your doctor or nurse that you are hurting after surgery, you can almost always get medicine to treat it right away. Pain due to surgery can last from a few days to a few weeks, depending on how extensive the surgery was.
Phantom pain: This is a longer-lasting effect of surgery, beyond the usual surgical pain. If you have had an arm, leg, or even a breast removed, you may still feel pain or other unusual or unpleasant feelings that seem to be coming from the absent (phantom) body part. Doctors are not sure why this happens, but phantom pain is real; it is not "all in your head."
No single pain relief method controls phantom pain in all patients all the time. Many methods have been used to treat this type of pain, including pain medicine, physical therapy, antidepressant medicines, and transcutaneous electric nerve stimulation (TENS). If you are having phantom pain, ask your doctor or nurse what can be done.
Pain from other cancer treatments
Some of the side effects that occur with chemotherapy and radiation treatments may cause pain for some people. Pain can even cause some people to stop treatment if it is not managed. Talk to your doctor or nurse about any changes you notice or any pain you have. Here are some examples of pain caused by treatment:
Peripheral neuropathy (PN): This condition refers to pain, burning, tingling, numbness, weakness, clumsiness, trouble walking, or unusual sensations in the hands and arms or legs and feet. Peripheral neuropathy can be caused by certain types of chemotherapy, though vitamin deficiencies, the cancer, and other problems can also cause it. Be sure and tell your doctor right away if you notice these kinds of problems.
Mouth sores (stomatitis or mucositis): Chemotherapy can cause sores and pain in the mouth and throat. The pain can be bad enough that people have trouble eating and drinking.
Radiation mucositis and other radiation injuries: Pain from external beam radiation depends on the part of the body that is treated. It can cause skin burns, mucositis (mouth sores), and scarring -- all of which can result in pain. The throat, intestine, and bladder are also prone to radiation injury, and you may have pain if these areas are treated.
Last Medical Review: 10/25/2010
Last Revised: 10/25/2010